Clinton, Munar and many other leaders in the fight against HIV/AIDS propose a continuation of the "get tested, use condoms" mantra with greater emphasis on lowering costs and expanding availability of antiretroviral medications.

They focus much hope on pre-exposure prophylaxis medications, abbreviated as PrEP.. The PrEP approach is to give antiretroviral drugs to HIV-negative people for use with condoms. Sorry, but I do not believe the hype. On Dec. 1, 2021 AIDS at 40 will be an epidemic, as it is today: with a disproportionate impact on poor people and African-American men who have sex with men, abbreviated as MSM.

Once every six months since 1989 I've tested negative for HIV in the Howard Brown Health Center's Multicenter AIDS Cohort Study, called MACS ( now run by Northwestern University ) . My identification number is 23075 and my mother's maiden name is Moore. I joined this study more than 20 years ago because I'd swallowed semen of HIV-positive partners and wanted to know the long-term results. On Dec. 7, 2011 I tested negative for HIV again, at age 57.

Nothing in my upbringing prepared me for witnessing 158 deaths of family, friends and acquaintances I knew and loved during this epidemic. More than 80% of those loved ones were lost to HIV/AIDS. HIV caused me to live with emotional depression for long periods of time. 1987 to 1996 was the worst decade. Some years featured a funeral a month, four and five months in a row.

To witness very close and dear friends go through bouts of extreme nausea and prolonged fatigue ( some at 6-feet tall weighed 125 pounds ) gave me extreme fear of AIDS by 1983. Before 1983 I thought AIDS was a problem for European-American gay men in California and New York. I was hopeful that medical science would isolate HIV and end the epidemic by 1985.

In the 1970s I came out to everyone in my family. My father and two uncles did not speak about my dating men with each other. Yet, each responded to my coming out by re-affirming their love for me, by telling me not to have anal sex, by telling me to continue to go to church and to encourage my lesbian and gay friends to become activists, viewing gay rights as a civil-rights issue.

By 1986 I'd read in several books and in credible magazine articles that the wafer-thin mucous membrane lining of the anus is subject to microscopic tears by pubic hair. While not necessarily painful or visible, those tears provide the virus direct access to the blood stream.

A fan of fellatio, I'd always thought intercourse to be for emotionally bonded monogamous partners. As the HIV/AIDS epidemic didn't end, but got far worse in 1986, my fear of AIDS grew. With no lover, with knowledge that anal intercourse is the most efficient way to sexually transmit HIV and with sincere advice from my uncles and father, I made a personal commitment. To stay negative for HIV I've kept 100% disciplined to this mantra: "No anal sex in any position, no exceptions."

For sure, condoms are 97% to 99% effective. But if the auto dealership that services my car said, "Your brakes will fail 1% of the time," then I'd have them keep the car until the brakes were fixed to work at all times. You never know when a drunk driver will dart in front of you on the expressway with traffic going 65 miles per hour! A 1% brake failure rate is an unacceptable risk.

In the darkness of the bedroom that 1% failure rate for condoms is an unacceptable risk, when a virus you must live with until you die is lurking.

Frottage, also known as grinding to orgasm and outercourse, allows semen to cover waterproof skin. Yet people supposedly interested in prevention of HIV transmission, even those in well-regarded HIV-prevention groups and organizations funded by the U.S. Centers for Disease Control, rarely affirm and promote the erotic pleasure and safety of frottage. President Bill Clinton's Surgeon General Dr. Joycelyn Elders actually was fired in the 1990s for saying masturbation is good for HIV transmission prevention.

If HIV/AIDS groups supposedly working for the prevention of the spread of HIV were serious about having a future generation free of AIDS, they would forcefully advocate among gay and bi men the erotic pleasure of mutual masturbation and frottage. And they would target gay and bi males with the mantra, "no anal sex in any position, no exceptions." Like me, they would run into a stone wall of resistance from men who have loved anal sex for years. Therefore men born in the 21st Century who will come out over the next 10 to 20 years will rarely get the message that a very enjoyable sex life does not have to include penetration, even with a lowered 1% risk for HIV that condoms provide.

In recent years my applications to work inside the system, at three HIV/AIDS prevention groups, have been turned down. The interviewer at the Chicago Department of Health thought I wasn't sufficiently concerned about the health of women. I responded that it is African-American men who have sex with men who are far more, indeed, most disproportionately impacted by HIV. That insistence on treating all people equally regarding risk of HIV transmission is one of many reasons why HIV is a permanent epidemic.

I perceive that supposed HIV/AIDS prevention agencies are bureaucracies. Bureaucrats tend to maintain the status quo. To them, "no anal sex in any position, no exceptions," would be too radical a position to adopt and to promote to gay and bi men. To them, anal sex is a pregnancy prevention method for heterosexuals.

Pharmaceutical companies have made HIV-positive people a colony ripe for long-term economic exploitation. Now they want to add in more gay and bi men who are negative for HIV.

From 1981 to 1987 Republican President Ronald Reagan ignored HIV/AIDS. In 2011-2012 all the Republican candidates for president, and many running for Congress, state and local office are under conservative Tea Party pressure to seek the repeal of President Obama's healthcare act. Many favor gay marriage, as long as the gay person marries a partner of the opposite sex. They even want to reinstate the failed "Don't Ask, Don't Tell" military gay ban, and don't forget to give more tax breaks to millionaires and billionaires to solve all problems of society.

The social forces responsible for conservatives to be prejudiced against LGBT people are social forces that cause too many LGBT people to accept and to internalize self-defeating social pressures. Often rooted in 19th Century religious misunderstanding of same-gender love, too many people find it easier to accept tradition than to challenge and change it. Taken to the extreme, "bug chasers" seek to become HIV positive, sometimes to get what they think are benefits like social-security income, subsidized housing, etc. A more mainstream thought is that you do not really have sex unless there is penetration. Frottage, fellatio and mutual masturbation are dismissed as mere foreplay.

From the start, considering HIV infection primarily to be a medical issue—with the emotional, cultural, racial, economic and religious forces minimized—has kept HIV on steroids and on stilts. Additionally the fear of fully disclosing "personal" information about "private" sexuality and drug and alcohol use make me a true believer that come Dec. 1, 2031 AIDS at 50 will be a permanent epidemic.

Max Smith is a long-time gay activist and he can be reached at MaxsonnCS@aol.com